The ultrasound room. It’s supposed to be full of joy, isn't it? Seeing those first fuzzy images of your little one. But sometimes, the quiet in the room gets a bit too heavy. #brainmalformations #cephalicdisorders #congenitaldisorders #fetaldevelopment #microcephaly #neuraltubedefects #spinabifida
#Newborns with #microcephaly in #Brazil and potential vertical #transmission of #Oropouche virus: a case series
Source: Lancet Infectious Diseases, SummaryBackgroundOropouche fever, an orthobunyavirus disease endemic in Brazilian Amazon, has caused many febrile epidemics. In 2024, an epidemic of Oropouche fever spread in Brazil, with more than 7930 cases reported between Jan 1 and Aug 31. Infections in pregnant people have suggested the possibility of negative fetal…
Source: Lancet Infectious Diseases, SummaryBackgroundOropouche fever, an orthobunyavirus disease endemic in Brazilian Amazon, has caused many febrile epidemics. In 2024, an epidemic of Oropouche fe…
Source: Lancet Infectious Diseases, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00617-0/abstract?rss=yes
Summary
Background
Oropouche fever, an orthobunyavirus disease endemic in Brazilian Amazon, has caused many febrile epidemics. In 2024, an epidemic of Oropouche fever spread in Brazil, with more than 7930 cases reported between Jan 1 and Aug 31. Infections in pregnant people have suggested the possibility of negative fetal consequences, therefore we tested newborns with microcephaly for known congenital pathogens and Oropouche virus (OROV).
Methods
In this case series, we assessed historical cases of infants born with microcephaly, arthrogryposis, and other congenital malformations without a confirmed cause and their mothers for potential OROV congenital infections. The study population consisted of infants born in Brazil with samples from 2015–21 and 2024. Serum and cerebrospinal fluid (CSF) from this case series were analysed for: syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes simplex, HIV, Zika, dengue, and chikungunya. Individuals that were negative for these pathogens were then tested for OROV. Pathogen testing included ELISA and haemagglutination inhibition testing for antibodies and RT-PCR for virus RNA.
Findings
We tested 68 samples from 65 historical cases of congential malformations and three cases from 2024. All cases were from ten states in Brazil. Three historical cases tested positive for OROV and 62 historical cases tested negative. The three cases from 2024 all tested positive for OROV. Of the positive cases, five were female and one was male. Not all pathogens were tested for each case, and some did not have maternal samples available. One of the newborns (case 6) died aged 47 days and tissue samples were tested by real-time RT-PCR, histopathology, and immunohistochemistry assays. One other newborn died in 2016 but no post-mortem samples were available. OROV IgM was detected in five of five newborn CSF samples, and five of five newborn serum samples. Four of five maternal serum samples were positive for OROV IgM. One of four newborn CSF samples (case 6 at age 44 days) was OROV positive by real-time RT-quantitative PCR and 0 of four newborn serum samples were positive, as were 0 of three maternal serum samples. Case 6 had major tissue changes of the brain macroscopically and microscopically, including necrotic and apoptotic changes of neurons, microglia and astrocytes, vacuolisation, and tissue atrophy. OROV RNA was detected in brain, lungs, kidney, CSF, and pleural fluid; OROV antigens were found in CNS, liver, kidney, heart, and lung, mainly in neurons and microglia and also in endothelial cells, suggesting vasculitis.
Interpretation
We detected OROV IgM in six of 68 newborns with microcephaly of unknown cause. One infant who died had OROV RNA and antigen in several tissues, including the brain. The possibility of OROV vertical transmission and potential fetal harm must be investigated with urgency. The evidence presented here does not completely confirm vertical transmission or congenital malformations due to OROV, but thorough case finding and detailed investigation of maternal or fetal OROV infection is a priority.
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#abstract #brazil #microcephaly #neuroinvasion #oropoucheVirus #orthobunyavirus #pregnancy #research
Source: Lancet Infectious Diseases {Correspondence}, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00618-2/fulltext?rss=yes
{Excerpt}
The possible vertical transmission of OROV deserves a swift, collaborative, scientifically rigorous, and ethically sound research response. Key findings from these investigations should be communicated to broader society in a timely and accessible manner. Ultimately, the biggest lesson learned from the congenital Zika research experience is that we cannot delay.
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#ARBOVIRUS #microcephaly #mosquitoes #oropoucheVirus #research
Potential #vertical #transmission of #Oropouche virus during current #outbreak, Lancet Infect Dis.: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00571-1/fulltext?rss=yes
Public health authorities have assessed #risk to human #health in #Americas as very high, with a high risk of further spread. As of Aug 19, 24, #Brazil has reported 7653 cases, with authorities investigating potential vertical transmission in a few cases. In June, 24, a retrospective analysis detected IgM Abs in serum & CNS samples from 4 #newborns with #microcephaly.
#Oropouche Virus (OROV) in #Pregnancy: An Emerging Cause of #Placental & #Fetal #Infection Associated with #Stillbirth & #Microcephaly following Vertical Transmission, Viruses: https://www.mdpi.com/1999-4915/16/9/1435
This communication examines biology, epidemiology, & clinical features of #OROV, summarizes the 2023–24 epidemic, & describes reported cases of vertical transmission & #congenital infection, fetal death, and #microcephaly in pregnant women with Oropouche fever,...
Oropouche virus (OROV) is an emerging arbovirus endemic in Latin America and the Caribbean that causes Oropouche fever, a febrile illness that clinically resembles some other arboviral infections. It is currently spreading through Brazil and surrounding countries, where, from 1 January to 1 August 2024, more than 8000 cases have been identified in Bolivia, Brazil, Columbia, and Peru and for the first time in Cuba. Travelers with Oropouche fever have been identified in the United States and Europe. A significant occurrence during this epidemic has been the report of pregnant women infected with OROV who have had miscarriages and stillborn fetuses with placental, umbilical blood and fetal somatic organ samples that were RT-PCR positive for OROV and negative for other arboviruses. In addition, there have been four cases of newborn infants having microcephaly, in which the cerebrospinal fluid tested positive for IgM antibodies to OROV and negative for other arboviruses. This communication examines the biology, epidemiology, and clinical features of OROV, summarizes the 2023–2024 Oropouche virus epidemic, and describes the reported cases of vertical transmission and congenital infection, fetal death, and microcephaly in pregnant women with Oropouche fever, addresses experimental animal infections and potential placental pathology findings of OROV, and reviews other bunyavirus agents that can cause vertical transmission. Recommendations are made for pregnant women travelling to the regions affected by the epidemic.
[Correspondence] #Oropouche #fever: #reports of vertical #transmission and #deaths in #Brazil https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(24)00557-7/fulltext?rss=yes
This situation recalls the 2015–16 Zika virus outbreak, which was marked by vertical transmissions resulting in severe cases of #microcephaly and other congenital #malformations, highlighting the crucial need for vigilant surveillance and rapid response.
Scientific Frontline
Dr Priya Sammani ( MBBS ,DFM )
Giuseppe Michieli
ETIDIoH
Eagle Globe & Flanker